Michetti G, Bamberga M, Pugliese C, Ori Belometti M, Arnone P, Minio A, Ciaravino G, Villa R, Alesina R, Cottini M
Divisione di Pneumologia, Ospedali Riuniti, Bergamo.
Minerva Med. 1994 May;85(5):231-6.
The clinical value of the serum biomarker carcinoembryonic antigen (CEA) was evaluated prospectively in 118 patients with small cell lung cancer (SCLC) entered chemotherapy protocol between 1986 and 1992. Five quantitative categories were determined: less than 2.5 ng/ml and 2.6-5.0 ng/ml (the standard normal), 5.1-20.0 ng/ml, 20.1-100 ng/ml and greater than 100 ng/ml. 70% of patients had levels less than 5 ng/ml and only 19% had levels greater than 20 ng/ml. There was no clearcut relationship of plasma CEA level to stage of disease, in which 61% of patients with extensive disease (59 patients) had levels less than 5 ng/ml and 22% of patients with limited disease (59 patients) had levels greater than 5 ng/ml. There was a modest relationship of CEA levels to presence of metastases, in that 50% of patients with metastases had levels greater than 20 ng/ml. The average survival for the pathologic and normal category was almost similar, ranging from 13.27 to 16.81 months. The correlation between disease extent and survival was more sensitive for lactate dehydrogenase (LDH) than for CEA. So CEA as a tumor marker for SCLC must be applied in conjunction with other biomarkers, particularly LDH and neuron specific enolase (NSE) and is meaningful in only a small proportion of patients.
1986年至1992年间,对118例接受化疗方案的小细胞肺癌(SCLC)患者进行了血清生物标志物癌胚抗原(CEA)临床价值的前瞻性评估。确定了五个定量类别:低于2.5 ng/ml和2.6 - 5.0 ng/ml(标准正常范围)、5.1 - 20.0 ng/ml、20.1 - 100 ng/ml以及高于100 ng/ml。70%的患者CEA水平低于5 ng/ml,只有19%的患者水平高于20 ng/ml。血浆CEA水平与疾病分期没有明确关系,其中61%的广泛期疾病患者(59例)CEA水平低于5 ng/ml,22%的局限期疾病患者(59例)CEA水平高于5 ng/ml。CEA水平与转移灶的存在有一定关系,即50%有转移灶的患者CEA水平高于20 ng/ml。病理和正常类别患者的平均生存期几乎相似,为13.27至16.81个月。疾病范围与生存期之间的相关性,乳酸脱氢酶(LDH)比CEA更敏感。因此,CEA作为SCLC的肿瘤标志物必须与其他生物标志物联合应用,特别是LDH和神经元特异性烯醇化酶(NSE),并且仅在一小部分患者中有意义。